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No one has mentioned this - but have you considered asking for a prescription for gabapentin as that is the main drug used for CM/SM pain? I presume that the vetergesic injection is something that he is not receiving on a regular basis but was just given initially, and he is only taking the tramadol at this point? I definitely wouldn't want to give vetergesic on any kind of regular basis as this is a pretty powerful opioid. This is not a drug that is commonly used for CM/SM pain.

Tramadol alone isn't very effective either for CM/SM pain. It is generally used to augment gabapentin or pregabalin.

You said that the vet is introducing NSAIDS - has that started yet and which one is under consideration?

I'd really recommend that you consider adding gabapentin asap rather than waiting for a neurology consult given the amount of pain that you describe.

Pat

Hi Pat, thanks so much for your post and the link re vetergesic,
The tramadol and vetergesic (not by injection) was prescribed 4 weeks ago and has been ever since, following the scan report last Friday I was advised to start Kookie on prednisolone, (I haven't done this) reduce the vetergesic gradually(I have done this) and keep him on tramadol for now. The vets intention is to remove tramadol and prescribed NSAIDS after we see how Kookie goes with the steroids. Before Kookie had the scan the vet told me they can't prescribe gabapentin without a diagnosis! Seems to me they don't consider CM as warranting gabapentin so I feel the best option at the moment is to get a neurologist opinion and she has agreed to make a referral to Dr Rusbridge.

'can't prescribe gabapentin without a diagnosis' Codswallop! If there is a delay in being able to get an MRI but the dog is in pain and CM/SM is likely, one of the things some vets do is to prescribe gabapentin and if it works, that in itself is a good indication of the presence of CM/SM or some other neurological problem, because gabapentin is not a general painkiller, it only works on neurological pain. Still, at least your vet is referring you, and Clare is incredible about making time for people, so hopefully you won't have to wait too long for proper advice.

'can't prescribe gabapentin without a diagnosis' Codswallop! If there is a delay in being able to get an MRI but the dog is in pain and CM/SM is likely, one of the things some vets do is to prescribe gabapentin and if it works, that in itself is a good indication of the presence of CM/SM or some other neurological problem, because gabapentin is not a general painkiller, it only works on neurological pain. Still, at least your vet is referring you, and Clare is incredible about making time for people, so hopefully you won't have to wait too long for proper advice.

Kate, Oliver and Aled

That's very interesting to know that Kookie could have been prescribed gabapentin 4 weeks ago, even now he hasn't been offered this despite my asking for a referral to the neurologist. Take today for instance, he is normally such an energetic little pup but he has been listless, restless at times but subdued, not even up for going a walk. I am sure you have experience of this as your little on suffers pain from CM/SM and it is comforting to have support in what seems to be a an up hill struggle to get the help he needs.

Originally Posted by Emkaybee

Just wanted to say I'm so sorry your Kookie is going through this, and I hope the doctors can help him.

I agree with what Kate has said about prescribing Gabapentin. Codswallop isn't quite the word I would use, but the stronger term I have in mind would get me thrown out of this list with a resounding thud

My local vet prescribes Frusemide, Metacam and Gabapentin for my boy who would otherwise have severe neuropathic pain from SM/CM without a problem, although I did give her a sight of his MRI pictures as soon as I received them from Chester Gates. Rebel is over 10 years old and quite comfortable and sprightly since establishing his treatment regime, which is proof enough for me that Gabapentin works well.

If you aren't getting the good working relationship with your vet after receiving advice from Stone Lion, then change the vet. End of.

I agree with what Kate has said about prescribing Gabapentin. Codswallop isn't quite the word I would use, but the stronger term I have in mind would get me thrown out of this list with a resounding thud

My local vet prescribes Frusemide, Metacam and Gabapentin for my boy who would otherwise have severe neuropathic pain from SM/CM without a problem, although I did give her a sight of his MRI pictures as soon as I received them from Chester Gates. Rebel is over 10 years old and quite comfortable and sprightly since establishing his treatment regime, which is proof enough for me that Gabapentin works well.

If you aren't getting the good working relationship with your vet after receiving advice from Stone Lion, then change the vet. End of.

Thanks FloSin,

It's great to know that others understand the problem of getting the right help for Kookie and I am grateful for all the advice from others who have gone down this road. Kookie suffered quite a bit of discomfort yesterday and during the night, with many scratching episodes, we had difficulty with grooming especially round the ears and eyes so he is clearly uncomfortable. Following the advice on here I rang the vet this morning informing her that Kookie has had another painful episode and asked if she can prescribe gabapentin whilst we await the neurologist's input. The vet said she will send the referral of today to Stone Lion, they won't have gabapentin at our local surgery as the drug is expensive but she will try to organise this for pick up later today. I don't want to make any rash decisions regarding the vet but if I encounter any problems following Dr Rusbridge's input then I would certainly consider this.

So sorry to hear your going through this with such a young pup, just when he should be running riot too.

If you do need to end up seeing a Neuro in person, I can assure you that Glasgow as fantastic, I can pick up the phone at anytime, or drop an email and get a very quick response. Both of mine get treated there, and one has also visited the pain clinic there to get further help in settling him down. Finding the right meds can be tricky, but once the right ones are found it can make a huge difference to how they behave.

And I wouldn't think twice about changing vets if you have any concerns, I had to switch vets as they didn't believe my first one to be diagnosed had SM, or that she needed a referral! Needless to say we no longer visit that practice

So sorry to hear your going through this with such a young pup, just when he should be running riot too.

If you do need to end up seeing a Neuro in person, I can assure you that Glasgow as fantastic, I can pick up the phone at anytime, or drop an email and get a very quick response. Both of mine get treated there, and one has also visited the pain clinic there to get further help in settling him down. Finding the right meds can be tricky, but once the right ones are found it can make a huge difference to how they behave.

And I wouldn't think twice about changing vets if you have any concerns, I had to switch vets as they didn't believe my first one to be diagnosed had SM, or that she needed a referral! Needless to say we no longer visit that practice

Thanks so much for your post and the recommendation re neuro in Glasgow and glad to hear that they have been fantastic with your two. That is certainly encouraging for the future should Kookie need to be seen in person. I feel the biggest hurdle has been having it recognised that CM alone can cause considerable pain in some cavaliers. I am thankful therefore that Kookie has been referred now by the vet to the neurologist who can make the final scan interpretation and recommendations.

I rang the vet this morning informing her that Kookie has had another painful episode and asked if she can prescribe gabapentin whilst we await the neurologist's input. The vet said she will send the referral of today to Stone Lion, they won't have gabapentin at our local surgery as the drug is expensive but she will try to organise this for pick up later today.

Try and film what your little dog does, it may help with the assessment A picture is much better than words.

Gabapentin is not that expensive & you do not need to buy it at the vet. It is a human drug so she can give you a private prescription & you can get it from any pharmacy. A lot of us use Boots or Tesco.

Margaret C

Cavaliers......Faith, The Ginger Tank and Woody.
Japanese Chins.... Dandy, Benny, Bridgette and Hana.
Remembered with love......... Tommy Tuppence and Fonzi

What you say about Gabapentin is so right Margaret. Because I have two long term ill Cavaliers and Rebel's age, the partners at my vet's decided to charge Rebel's meds at cost with nothing added on for profit. This means that I pay very little, something like about £20 a month for everything he takes. They do of course charge £25 or so for his 3 month consultations though, but that includes his 6 monthly blood tests. They also send me monthly invoices, which means that I can pay by CT at a time to suit me.